Managed Care Can Be Mastered With Cooperation
The story headlined “ODs Accept Managed Care – Grudgingly” in the Jan. 25, 1993, issue of Vision Monday reminds me of the story of two people riding a bicycle built for two up a steep hill. Upon reaching the top of the hill after an arduous climb, the rider in front turns to his companion and says, “That was one tough climb!” To which his partner replies, “It sure was. If I had not kept my brakes on all the way up, I am afraid we would have slid all the way back down.”
My point is simply this: If change is inevitable (and, according to the Vision Monday/Optometry Today Roundtable’s conclusion, managed care is here to stay), then perhaps it makes more sense to pedal together rather than fight against one another.
As a pioneer in the managed vision care field, we have long recognized the necessity of incorporating the needs and concerns of all parties in the equation of a workable formula. This was/is no small task. By definition, the needs and concerns of buyers and sellers (read patients and providers) are diametrically opposed.
However, through a professionally organized, qualified, credentialed third party (HMO, PPO, insurance company, etc.) these disparate needs/concerns can be satisfactorily resolved. Cooperation is an absolute necessity. One small example of such cooperation follows: Several years ago our Professional Advisory Board cautioned us about the onerous paperwork required by certain third party vision plans. After some discussion, we devised a way to eliminate any paperwork requirements on the part of the provider, and allow for payment of all fees to the provider at the point of service (no delayed reimbursements). The patient receives quality, professional care while realizing savings through the managed care network mechanism. Everyone wins.
Cooperation is the reason why Spectrum Vision System Inc. represents more than 3,500 independent ophthalmic professionals, 20,000 companies, and 3.5 million members in managed vision care throughout the United States.
Chairman & CEO
Spectrum Vision Systems Inc.
Preferred Vision Care
Overland Park, Kan.